KEVIN: How is Babby Formed

A large portion of my OB/GYN rotation was obviously spent with pregnant women, who spend a lot of time preparing for baby, either at the hospital, or at Babies R Us, or working, until baby becomes #1 priority. How anyone could assume that responsibility was and is beyond the understanding of my Y chromosome. What if you accidentally eat a tuna sandwich or forget your folate one day? What if your boss has a pretty, young, not pregnant thing ready to replace you if your well check takes too long? What if you trip on a pebble and fall on your tummy, your arms too slow and edematous to lessen the impact? The end product of the pregnant state, once emerged, serves to chronicle your performance during the most stressful 40 weeks of your life. And then you have to raise the thing. Ugh.

My mom, a 5 foot, 95 lb woman, proudly volunteered that I was born via vaginal delivery, 8 lbs 8 oz at 41.3 weeks. Although never spoken, the insinuation was that childbirth forever delegates women as the stronger gender. I realized that I was perfectly comfortable with this arrangement.

I waylaid my cynicism after I laid hands on a fresh, sterile, stinky newborn baby, simultaneously the ugliest and yet the cutest thing. A hundred billion have mostly turned out okay so far, largely devoid of input from men. So I hereby accept my responsibility of foot massages, back rubs, home cooked dinners, and, of course, adherence to ACOG guidelines in pregnant care.

1. Internal Medicine
2. Emergency Medicine
3. Pediatrics
4. Psychiatry
5. Dermatology
6. Family Medicine
X. Ob/Gyn
X. Anesthesiology
X. General Surgery
X. Radiology

KEVIN: There’s an [operation] For That

We M2s are well into our rotation schedule for the year. Slowly but surely, we are eliminating career choices and gravitating toward others. I’m halfway through general surgery right now, and while I appreciate the work and am impressed by a surgeon’s work ethic, I’m not sure if I belong here. The service has been sending me hints:

1. Clinic is more fun than the OR
2. My resident said that the best advice from her residency advisor was to avoid surgery, unless she wanted to marry it and have hella babies with it
3. My fellow admitted that he couldn’t figure out how to get to Kroger without asking his wife
4. I got bile in my eye…during a laparoscopic operation.

But everyone is different! It behooves the undecided to ask questions and explore as much as possible. Join me, then, in my reckless pursuit of a life-defining career. I’ll try updating this list every few months and include new specialties that I’ve been exposed to.

1. Medicine: The default for the undecided leaves room for a later decision.
2. Pediatrics: I’m at Egleston right now, and I think kids — even sick ones — are more manageable than I previously thought. Plus, videogames at work.
3. Psychiatry: The “biopsychosocial” approach to mental health is an appealing challenge. Bonus points for people giving you the stink eye when you tell them your job.
X. everything else
X. Anesthesiology: The motto of anesthesiology is “vigilance.” Adherence to this principle is difficult when you have the distractability of a goldfish.
X. General Surgery: (see above)
X. Radiology: The lifestyle is great and the skills are respected, but the wandering spirit is not calmed by computer work.

Short update, so here is a comic (credit Michelle Au @ Scutmonkey):

KEVIN: *blows dust off blogging keyboard*

A few of us have completed our very first clinical rotation of the new curriculum. Rotations are set up in two-month blocks; the “big” ones take up all eight weeks of the block, while the “smaller” ones are combined. For example, Medicine is eight weeks long, while Radiology’s two weeks are combined with Psychiatry’s six weeks. This makes sense for organizational reasons — everyone will be on a new rotation every eight weeks.

Having just completed my Radiology rotation, I actually learned some useful skills that should help me during my “big” rotations. I appreciated not having to study nearly as much as I did during, say, Step One. (Which, by the way, did not suffer any worse scores from our class, if whisperings are to be believed. But you didn’t hear it from me.) One of the residents I followed during my rotation graciously dug up an old case of situs inversus, which Scrubs fans will immediately recognize.

Two weeks was not nearly enough time to confirm Radiology as a future career choice, but it did allow many of us to rule out Radiology as such. In any case, I think most of us are excited about seeing patients than reading chest X-rays, so next week’s Psych rotation should be a lot of fun.

As a non sequitur, here is a picture of the White House that I took during Inauguration Day

KEVIN: Top Nine Signs of Interview Season

9. Disappointment that nobody from your school is interviewing today (only valid if you graduated from Berkeley)
8. Interviewees asking frantically which AdComm official to send thank you notes to
7. Best study room in building no longer free
6. M1s weary of EBM (Evidence-Based Medicine)
5. M2s still learning EBM
4. Before checking their Facebook in lecture, students quickly check over their shoulders for the prying eyes of interviewees.
3. Free Coke and cookies
2. Erica sends veiled threats to students who steal interviewees’ Coke and cookies
1. Kevin updates his EUSOM blog

KEVIN: Ice to See You

Since I last posted, we’ve finished our first year and had an epic three week vacation. The new M1s have started their classes, and their bright faces are a welcome sight compared to ours, which have grown haggard, worn, wrinkly and old. Personally, I’ve moved into my new place in downtown Decatur, and am gradually stocking the place with furniture. This is an insidious process, and when your furniture doesn’t arrive for FIVE WEEKS, you must adapt:

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Two weekends ago, I attended my friend’s wedding in San Jose, CA. It was a fantastic event. My brain can’t begin to comprehend the amount of time, energy, and money that went into the whole thing. Hundreds of guests, a twelve course dinner, enormous wedding cake, and about 3000 wine bottles are but wedding staples these days. Newer weddings are all about the ice sculptures, photobooths for your guests (and their girlfriends) to take pictures to paste into your sign-in book (this was actually brilliant), and live dance performances by America’s Best Dance Crews:

http://www.youtube.com/watch?v=yS19igjtXPg (skip to 1:55)!

The twist is that my friend was planning this event while completing his first year of medical school at the University of Wisconsin – similar to the four people in my class who also tied their knots during their summer breaks. The takeaway message is that your social life doesn’t disappear with medical school, as far as I can tell. It is certainly possible, and recommended, for students to modify their social lives to fit their education, spending their free time planning or attending weddings.

If anyone out there is reading this and still deciding where to apply, my advice to you is to find a school where students have at least some modicum of flexibility in their lives.

(Apply to Emory)

KEVIN: No really, it’s not lupus

A 23 y.o male patient visits you for his annual checkup. He reports no emergent symptoms and feels generally “fine.” However, you notice a stiffness in the way that he walks, as if his thighs were sore. On thoracic examination, you observe several red welts, with no apparent pattern, about the size of a half dollar that circumscribe an unraised area. The lesions are tender to the touch.

What is your next action?
A. Assess the patient for erythema multiforme
B. Berate yourself for not getting a more complete history
C. Congratulate the patient for an evening well spent, the sly devil
D. Tell the patient to stop being terrible at paintball

Most “professional” caregivers will answer B, and I’m pretty sure answer C will get you into trouble. But since it’s my question, the answer is D. And yes, I’m referring to myself. A group of us med students visited Paintball Atlanta last Saturday on a lark. I almost did not attend, but had fond memories of my previous paintballing experience in high school. Nothing can quite replicate the sharp welts and sore thighs that accompany the sport.

All in all, we had fun and we got to relieve some studying-related tension. We ended up on different teams, but since all the real players had their own paintball markers and camouflage gear, we managed to drag our respective teams down, such that the playing field was level. And, despite my own general paintball inadequacy, I’ll claim that I didn’t make it out the worst. Here are some of my favorite lesions from the day:

This bearded fellow had some suspicious new marks:

This leg is not mine:

We kept track of which round it was based on how many times Lynn had been shot in the head and neck:

And a picture of the group posing in front of a nice car and a Waffle House:

KEVIN: “I was born here”

By most accounts, Emory SOM has one of the latest spring breaks in any school. Ours was in mid-April, and mine was not particularly eventful. I spent some time with the girlfriend and also some other friends who still live back home.

I frequently forget that San Francisco can be a chilly, windy city, and I was fiercely reminded of this fact during my break. The girlfriend, herself a transplant from LA, wanted to visit our beach. The sight was worse than usual:

I had completely forgotten that we had an oil spill last November, which hasn’t yet been cleaned. We watched children and dogs play in sand-grease for about ten minutes and then left.

This was actually the highlight of my vacation.

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I’ve actually been postponing my entry until someone else mentioned the FANTASTIC Kanye West concert that we attended on Sunday night. Although Mr. West hails from “Chi-town,” he was born in “A-town” and made note of it during the show, during his performances of “The Good Life” and “Homecoming.” Ant and Tony were there and I am hoping that they managed to sneak a camera into the show. If any of you readers have a chance to attend one of the tour’s stops, I highly recommend doing so, especially if you like having your senses assaulted by fog, fire, light, and live music.